In vitro evaluation of aspiration of hyaluronic acid filler with a new saline flashing method

Abstract

Aims In vitro evaluation of aspiration of viscous hyaluronic acid (HA) fillers through dermatologic needles, with and without a new solution for safe aspiration with a saline flashing procedure. The final objective is to be able to offer an easy‐to‐use device for a practitioner who injects fillers under and into the skin blindly. This device aims to protect him from an immediate and reproducible intravascular venous or arterial injection whatever the type of product used and independently of its rheological properties or the diameter of the needle used. Materials and Methods We performed in vitro aspiration experiment using syringes and commonly used needle sizes (27G, 29G). We measured the time to observe a blood being aspirated through the needle with HA filler. Intervals longer than 10 seconds were considered as false results. We added a new approach of flashing a saline solution through the needle with a filler prior to aspiration. Saline solution pressurized by a syringe plunger opens a fluid path in the needle and enables the successful and efficient aspiration in 1‐2 seconds through smallest needle size for 6 commercial HA fillers. Conclusion The saline flashing of the dermatological needles with HA fillers appeared to be a feasible and efficient solution for the 100% safe aspiration safety test. Results Aspiration was possible only in few trials with HA fillers for the 27G and all false for 29G needle, respectively. The aspiration with the novel saline flashing procedure is successful for 100% of cases with the two commonly used HA fillers and all needle sizes. The time to aspiration is also significantly shorter with the saline flashing.

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

“…Although the real-time clinical utility of pre-injection aspiration is controversial, [74][75][76][77][78][79][80] all injectors are ultimately aligned in avoidance of intravascular incidents. No single method guarantees safety, despite individual preference for aspiration or constant needle movement, thus the following should be borne in mind.…”

Aspiration before tissue filling with hyaluronic acid‐safety enhancement by using a lidocaine‐primed syringe

“…The amount of lidocaine is about 0.02 mL, which had been calculated by the mark line of HA barrel. “A irregular line” would sometimes appear along with the wall of the HA syringe while lidocaine was being sucked to the HA syringe 13 . It will be limited in the front hub of the HA syringe in most of the aspirated practices.…”

“…"A irregular line" would sometimes appear along with the wall of the HA syringe while lidocaine was being sucked to the HA syringe. 13 It will be limited in the front hub of the HA syringe in most of the aspirated practices. This tunnel contains lidocaine, which would be injected to the target spot.…”

Aspiration: I don't do it and neither should you

“…Recent research does provide hope that refinements in aspiration technique such as saline flashing and ultrasound may improve sensitivity and reliability, but conclusive evidence is still lacking 8,9 . My hope rests in smart needles such as the S3 Inject (Blossom Innovations) giving the injector real‐time feedback on the location of the needle tip.…”